We the undersigned, individual members of the firm or officers of the
Corporation as named above, each agree to abide by the Constitution, By-Laws, Rules and
Regulations of : The Independent Insurance Agents of
____________________________________, and to the Code of Ethics of the Independent
Insurance Agents of America, Inc. and the Insurance Laws in the State of Maryland, if and
when admitted to membership.
Name:_____________________________________________
Name:_____________________________________________
Name:_____________________________________________
Name:_____________________________________________
Date:____________________
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